Kornimate/medical-research-clean huggingface dataset:
promoting cholesterol screening

Conditions: Cardiovascular Diseases; Lipid Testing; Primary Prevention of Cardiovascular Disease

Summary: cholesterol screening is an important prerequisite for cardiovascular disease (cvd) risk assessment. cholesterol screening is recommended by the united states preventive services task force (uspstf). since reminder systems have been shown to modestly improve the rates of preventive services, including in safety net settings, we will implement patient-directed reminders to health center patients who meet our eligibility criteria. the aim of this study is to determine if a mailed outreach message and facilitated ordering of screening lipid tests increases cholesterol screening test completion within 3 months among federally qualified community health center patients who are eligible for screening compared to usual care.


Eligibility criteria:
inclusion criteria: * patient at participating health center * at least 1 visit to clinic in the prior 12 months * no total cholesterol and high-density lipoprotein cholesterol result recorded in the electronic health record in the past 5 years * no cholesterol screening order placed within the previous 3 months * men 35-75 years old, or women 45-75 years old who also have one of the following: hypertension, obesity, or current smoking exclusion criteria: * previously diagnosed cardiovascular disease, peripheral arterial disease or diabetes mellitus * statin on active medication list * preferred language other than english or spanish

Keywords: cholesterol screening high cholesterol cardiovascular disease statin treatment
recovery after dialysis-requiring acute kidney injury

Conditions: Acute Kidney Injury

Summary: the recovery after dialysis-requiring acute kidney injury (rad-aki) pilot study is a 2-arm randomized clinical trial of hospitalized patients with dialysis-requiring acute kidney injury (rad-aki), comparing conventional thrice-weekly intermittent hemodialysis dialysis (control) to a "conservative dialysis strategy" in which hemodialysis is not continued unless specific metabolic or clinical indications for rrt are present. the overall hypothesis is that the current practice of thrice-weekly acute intermittent hemodialysis for aki-d masks evidence of renal recovery and may actually delay or preclude recovery. the primary objective of this pilot study is to assess the safety and feasibility of the proposed intervention and study design.

the recent landmark artificial kidney initiation in kidney injury (akiki) trial showed that a delayed strategy for rrt initiation among patients with incident stage 3 aki - in which rrt was delayed unless specific metabolic or clinical indications for rrt were present - was safe and averted the need for rrt in nearly half of the critically ill participants, in comparison to an early rrt initiation strategy. the hypothesis for this study is: for prevalent patients with established aki-d, a conservative dialysis strategy - in which hemodialysis is not continued unless specific metabolic or clinical indications for rrt are present - will shorten time to rrt-independence and improve the likelihood of renal recovery. the rad-aki pilot study is a 2-arm randomized clinical trial of hospitalized patients with dialysis-requiring acute kidney injury (rad-aki) that will compare conventional thrice-weekly intermittent hemodialysis dialysis (control) to a "conservative dialysis strategy." the primary objective of this pilot study is to assess the safety and feasibility of the proposed intervention and study design.

Eligibility criteria:
inclusion criteria: * adult inpatients with aki-d due to acute tubular necrosis who have already initiated renal replacement therapy * if initiated on crrt, patients will be eligible only if they have already tolerated 1 intermittent hemodialysis (ihd) session at the research site. * if transferred from an outside hospital, eligible patients must have tolerated 1 ihd session at the research site prior to enrollment. * not requiring vasopressor support * not intubated and not having a supplemental oxygen requirement of \>5 l/min via nasal cannula * treating mds (nephrology and primary team attendings) and patient (or legally authorized representative) consent to enrollment exclusion criteria: * diagnosis of end-stage renal disease (esrd) or chronic dialysis prior to hospitalization * baseline estimated glomerular filtration rate (egfr) \<15 ml/min/1.73m2 * liver transplant unit patients * patients who underwent kidney transplantation during index hospitalization * cause of aki-d is complete nephrectomy * current pregnancy

Keywords: dialysis-requiring acute kidney injury renal recovery
gnrh agonist trigger and modified luteal phase adding a bolus of gnrha at the time of implantation: a rct

Conditions: Infertility

Summary: purpose:the aim of this project is to prospectively determine whether a single dose of gnrh-agonist administered at the time of implantation increases or not the reproductive outcome in patients undergoing in vitro fertilization ( ivf)/ intracytoplasmatic sperm injection(icsi) triggered by a gnrh-agonist followed by a small bolus of human chorionic gonadotropin (hcg 1500 iu) the day of oocyte retrieval.

it has been reported in previous publications that the ovarian hyperstimulation syndrome (ohss) was eliminated when gnrh agonist was used to trigger ovulation and the delivery rate has improved after modified luteal support especially when a small bolus of hcg is used on the day of oocyte retrieval. (omega/hcg 1500 iu). however, a risk difference of 7% in delivery rates is still in favor of hcg trigger. thus, further modifications in the luteal phase supplementation are required in order to optimise the reproductive outcome after gnrh-agonist triggering. recently, many papers showed, that independently of the gnrh analogue used to prevent the premature lh surge, the addition of gnrh-agonist during the luteal phase seems to be beneficial in terms of pregnancy. nevertheless, their use in practice is not yet admitted because of controversial results in terms of efficacy and safety particularly on the conceptus.

Eligibility criteria:
inclusion criteria: female age \< 40 years no uterine (fibroids, mullerian malformations), ovarian ( endometrioma) or adnexa (hydrosalpinx) abnormalities• baseline fsh and lh \< 12 iu/l.patients with at least one embryo at transfer time exclusion criteria: * very high risk of ohss (\> 30 follicles \> 12 mm the day of ovulation triggering). • reduced ovarian reserve * fertilization failure * severe endocrinopathy * azoospermia

Keywords: gnrh agonist trigger ivf luteal phase support mid-luteal gnrh agonist
the correlation between hair cortisol level of acute stroke or its long term disability.

Conditions: Cerebrovascular Stroke

Summary: in patients admitted to hospital with acute cerebrovascular stroke, we want to study the relationship between hair cortisol levels and biomarkers of inflammation and the clinical and radiological severity of the stroke and the degree of neurological disability being tested in three months and one year after.

the study will include patients hospitalized due to an acute cerebrovascular stroke. a number of 30 patients aged 40-70 will be included. within 48 hours of the event, blood inflammatory biomarkers, and scalp hair sample for cortisol will be taken. all recruited patients will undergo full neurological examination and the severity of the stroke will be rated using nihss (national institutes of health stroke scale). 3 months and one year later neurological examination and rating of neurological disability will be determined using rankin scale.

Eligibility criteria:
inclusion criteria: 1. patients aged 40-80. 2. acute cerebrovascular stroke (symptoms that began no more than 72 hours before) 3. rankin 0-1 before the event exclusion criteria: 1. suspicion or known cushing's syndrome 2. known adrenal failure 3. chronic inflammatory disease 4. active malignancy 5. acute infectious disease within 4 months before enrollment

Keywords: acute cerebrovascular stroke
implementation of the acp guideline for low back pain (impact-lbp)

Conditions: Pain, Back

Summary: the purpose of this study is to assess whether the primary spine practitioner (psp) model of care will lead to improvements in patient outcomes, as compared to usual care, based on change in patient-reported promis pain interference and physical function from baseline to 3 months in patients aged 18 years and older with a primary complaint of low back pain (lbp).

this study is a pragmatic, multi-site, two-arm cluster-randomized trial with the unit of randomization at the primary care clinic level. the overall goal is to evaluate implementation of the american college of physicians (acp) guideline for lbp by assessing the comparative effectiveness of the psp model, which involves first contact care for lbp patients from either a physical therapist (pt) or a doctor of chiropractic (dc), versus usual care, which involves first contact care with primary care physicians. the study includes patients aged 18 years and older with a chief complaint of lbp. co-primary endpoints to be assessed are changes in patient- reported outcomes measurement information system (promis) pain interference and physical function from baseline to 3 months. the investigators have chosen to use these co-primary endpoints as they represent two domains that are important factors related to patient improvement. secondary endpoints collected at baseline, 3, 6 and 12 months include pain catastrophizing scale - 4-item short form, promis global-10 (v1.2), opioid use, imaging and diagnostic testing, provider visits, and lbp-associated procedures and treatments: surgical procedures, medication prescriptions, hospital admissions and emergency room visits. additional exploratory analyses among enrolled patients will assess whether the psp model leads to 1) long-term improvement compared to usual care using the promis pain interference and physical function at 6, 12, and 24 months; and 2) lower healthcare utilization and costs for lbp at 12 and 24 months. patients enrolled within the first 12 months of the data collection phase will be included in the 24-month exploratory analyses. additional analyses will evaluate lbp-related utilization within the academic healthcare systems among all patients seen in intervention versus control primary care clinics utilizing de-identified clinic level data extracted from the ehr. a total of approximately 1,800 patients who seek care at a participating primary care clinic with a complaint of lbp and meet study eligibility criteria will be enrolled.

Eligibility criteria:
inclusion criteria: 1. aged 18 years and older 2. initiating an outpatient visit for lbp at a participating pcp clinic 3. agree to participate and complete baseline questionnaire (in lieu of formal written documentation of consent) exclusion criteria: 1. inability to provide consent or complete outcome questionnaires 2. positive screening for cauda equina symptoms (loss of total control of bowel/bladder associated with this episode of lbp )

Keywords: pain back pain low back pain primary spine provider
study of mometasone furoate/formoterol fumarate (mf/f) metered dose inhaler (mdi) in adolescents & adults with persistent asthma (p08212)

Conditions: Asthma

Summary: the purpose of this study is to assess the safety, tolerability \& effectiveness of 2 strengths of mometasone furoate/formoterol fumarate (mf/f) metered dose inhaler (mdi) in the treatment of persistent asthma in adults \& adolescents.


Eligibility criteria:
inclusion criteria: * diagnosis of asthma of at least 6 months duration * current use of a medium or high daily dose of an inhaled corticosteroid (ics) (alone or in combination with a long-acting beta agonist \[laba\]) for at least 6 weeks prior to screening and must be on a stable asthma regimen (daily dose unchanged) for at least 2 weeks prior to screening * agrees to change asthma therapy (if changing asthma therapy poses no inherent risk) * if female of reproductive potential, agrees to remain abstinent or use 2 acceptable methods of birth control during study participation. acceptable methods of birth control are: intrauterine device (iud), diaphragm with spermicide, contraceptive sponge, condom, vasectomy, hormonal contraceptive exclusion criteria: * treatment in the emergency room (for a severe asthma exacerbation), or admitted to the hospital for management of airway obstruction within previous 3 months * any prior ventilator support for respiratory failure secondary to asthma, * upper or lower respiratory tract infection (viral or bacterial) within previous 2 weeks * history of a medical condition that, in the investigator's opinion, may interfere with study participation, * history of smoking within previous year or a cumulative smoking history of more than 10 pack-years * known allergy to or intolerance of icss, labas, or any of the ingredients included in the study medications * history of use of illicit drugs * inability to correctly use an oral mdi * pregnant, breastfeeding or plans to become pregnant during study
use of the xcelligence system for quantification of bacterial biofilm's real time formation and antibiotics selection.

Conditions: Chronic Periodontitis; Periodontal Bone Loss; Resistance Bacterial

Summary: the aim of the study is to develop an in vitro model of growth of oral biofilms, and validate xcelligence system for the selection of an effective antibiotic treatment for each patient.

periodontitis in a chronic disease caused by bacteria present in the subgingival flora, which induces an inflammatory response of periodontal tissues. it has been suggested that some periodontal pathogens may be inaccessible to mechanical periodontal therapy due to its ability to invade the gingival tissues and evade defense mechanisms of the host. therefore, it is conceivable that coadjuvant administration of antimicrobials may improve the outcome of mechanical therapy. there are several techniques to monitor periodontal pathogens and determine antibiotic therapy. but the most important disadvantage of conventional laboratory methods is that they are indirect, based on the molecular detection of 3 to 10 bacterial species, without analyzing whether the biofilm as a whole is sensitive or resistant to treatment, being a possible cause of failure and / or recurrence of the disease, in addition to the risk of development of antimicrobial resistance. the investigators hypothesis is that the specific selection of antimicrobial treatment with the xcelligence system allows better improvements in clinical parameters than indirect laboratory methods. materials and methods: a randomized double-blind clinical trial will be launched. samples of subgingival plaque will be taken with paper tips. subjects included in the study will be randomized to one of 3 treatment groups: scaling and root planing combined with systemically administration of antibiotic suggested by the xcelligence system; scaling and root planing combined with systemically administration of antibiotic suggested by 'echevarne' laboratory and scaling and root planing combined with systemically administration of antibiotic suggested by 'origen' laboratory.

Eligibility criteria:
inclusion criteria: 1. subjects of 40-70 years. 2. no smokers or smokers of less than 10 cigarettes a day. 3. patients with periodontitis stages iii and iv grades a-b. 4. presence of 20 natural teeth, including at least three molar teeth. 5. presence of at least 4 sites with at least 6 mm probing depth. 6. good general health exclusion criteria: 1. smokers of more than 10 cigarettes a day. 2. patients who have received periodontal treatment in the previous 12 months. 3. patients who have used antibiotics in the last 6 months. 4. routine use of oral antiseptics and / or during the previous 3 months. 5. systemic conditions that required antibiotic premedication. 6. women pregnant or nursing. 7. medications that could influence the outcome of periodontal therapy. 8. any known allergies to the test antimicrobial agents. 9. diabetics.

Keywords: periodontitis microbiome dysbiosis homeostasis dental plaque antibiotics
correlating time-lapse parameters detected by the eeva™ system with comprehensive chromosome screening results

Conditions: Infertility

Summary: the purpose of this research study protocol is to collect imaging data on embryos followed to blastocyst stage (day 5-6) and correlate eeva system parameters with comprehensive chromosome screening (ccs) results, implantation and live birth.

the present study was designed to determine if there is a correlation between the eeva system parameters and ccs results. embryos will be selected for transfer based on ccs results and morphology. the clinical site will have no access to the eeva analysis at the time of the transfer.

Eligibility criteria:
inclusion criteria: * subject is ≤43 years of age. * women undergoing fresh ivf treatment using her own eggs or donor eggs and undergoing ccs, as recommended based on medical need by the clinical site reproductive endocrinologist. * fertilization using only ejaculated sperm (fresh or frozen) - no surgically retrieved sperm. * willing to have all 2pn embryos monitored by eeva * not previously enrolled in this study. * no concurrent participation in another clinical study. * willing to comply with study protocol and procedures and able to speak english. * willing to provide written informed consent. exclusion criteria: * bmi ≥ 40 * prior ivf cycle with \< 4 x 2pn * diminished ovarian reserve as demonstrated by any one of the following: * bafc \< 6 at time of cycle start * maximum prior fsh \> 15 * amh \< 0.5

Keywords: in vitro fertilization assisted reproduction techniques noninvasive imaging of embryos time lapse imaging of embryos traditional morphological grading of embryos prediction of blastocysts infertility preimplantation genetic diagnosis comprehensive chromosome screening
pyrotinib in combination with trastuzumab in treatment-refractory, her2-positive metastatic colorectal cancar.

Conditions: Colorectal Cancer

Summary: this clinical trial aims to evaluate the efficacy, safety of pyrotinib in combination with trastuzumab in treatment-refractory, her2-positive metastatic colorectal cancar.


Eligibility criteria:
inclusion criteria: patients should be histologically diagnosed with metastatic colorectal cancer or postoperative recurrence; patients with alk mutation(including mutation, fusion, rearrangements ); patients have measurable lesions; patients are not available for targeted therapy or patients refuse to receive targeted therapy afer second-line treatment; over 3 weeks after radiotherapy and the radiotherapy focus was not be measured; age should be 18-25 years; performance status should be 0-2; life expectancy should be more than 12 weeks; exclusion criteria: patients underwented major surgery or severe trauma within 4 weeks; patients allergiced to experimental drugs; patient ready to give birth or who is pregnant; patients with brain metastases; patients with chemotherapy contraindication; patients could not tolerate chemotherapy; patients have secondary primary tumor.

Keywords: her2 pyrotinib trastuzumab metastatic colorectal cancar
safety and preliminary efficacy of atg-017 monotherapy or combination therapy with nivolumab in advanced solid tumors and hematological malignancies

Conditions: Solid Tumor; Hematological Malignancy

Summary: this is a phase i, multi-center, open-label study of atg-017 administered orally, alone or in combination with nivolumab in patients with advanced solid tumors and hematological malignancies. the study is composed of two modules: atg-017 monotherapy (module a) and atg-017 in combination with nivolumab (module b). both modules a and b will include dose escalation phase and dose expansion phase.

the dose escalation of atg 017 will be conducted with intensive safety monitoring to ensure the safety of the patients with solid tumors (module a and module b) and hematological malignancies (module a) harbouring activating alterations in the ras-mapk pathway, and will include the continuous and intermittent dosing schedules. the dose expansion phase will start based on dose level and schedule (continuous or intermittent)

Eligibility criteria:
inclusion criteria: 1. provision of signed and dated, written informed consent prior to any study specific procedures, sampling and analyses. 2. aged at least 18 years. 3. module a: patient must have a documented activating alteration of the ras-mapk pathway. 4. module b: dose escalation phase: patient must have a documented activating alteration of the ras-mapk pathway; dose expansion phase: expansion cohorts will be further defined based on information from the dose escalation. 5. histological or cytological confirmation of a solid tumour. 6. patient with solid tumors must have at least 1 lesion, not previously irradiated. 7. estimated life expectancy of minimum of 12 weeks. 8. eastern cooperative oncology group (ecog) performance status 0 or 1. 9. ability to swallow and retain oral medication. exclusion criteria: 1. central nervous system metastatic disease, leptomeningeal disease, or metastatic cord compression. 2. prior atg-017 administration in the present study. 3. prior treatment with an erk1/2 inhibitor. 4. prior major surgery within 28 days of the first dose of study treatment or minor surgical procedures ≤7 days. 5. patients receiving unstable or increasing doses of corticosteroids. 6. as judged by the investigator, any evidence of severe or uncontrolled systemic diseases. 7. active infection including hepatitis b, and/or hepatitis c. 8. known history of human immunodeficiency virus (hiv) infection. 9. inadequate bone marrow reserve or organ function -
an epidemiological study to investigate the characteristics of rsv infection in adult hematopoietic cell transplant recipients or hematological malignancies patients in tianjin hi (hematology institute)

Conditions: RSV Infection

Summary: this primary objective of this study is to describe the incidence of rsv infection in adult hematopoietic cell transplant recipients or hematological malignancies patients in tianjin hi.


Eligibility criteria:
inclusion criteria: * 1) aged ≥ 18 years old. 2) receiving hematopoietic stem cell transplantation; or being diagnosed with hematological malignancies (including but not limited to leukemia, lymphoma, and multiple myeloma) and receiving chemotherapy. 3) new onset of respiratory symptoms; or exacerbation of existing chronic respiratory symptoms (such as previously diagnosed chronic runny nose, seasonal allergies, chronic lung disease, etc.). 4) willing to sign an informed consent form, able to understand and willing to follow the study protocol. exclusion criteria: * unwillingness to sign an informed consent form.